MINIMAL CHANGE DISEASE, THE LEADING CAUSE OF GLOMERULOPATHIES IN PAEDIATRIC POPULATION AT PESHAWAR

Authors

  • Ahmad Zeb Khan
  • Aziz Ahmad

Abstract

Background: Glomerulonephritis (GN) is a relatively rare disease with numerous subtypes. Mostregional nephrology centres see only a limitednumber of patients with each type of GN every year. Theobjective of this study was to find out the pattern of glomerulopathies in paediatric population,undergoing renal biopsy in Peshawar. Methods: This was a prospective study carried out at theDepartment of Nephrology, Khyber Teaching Hospital, Peshawar from May 2002 to May 2004.Ultrasound guided percutanous renal biopsies were carried out in patients with the findings of: 1)Nephrotic range proteinuria in children, 2) Non-nephrotic range proteinuria with evidence ofhypertension/haematuria/deranged renal function or active sediments on urine microscopy, 3) Steroidresistant nephrotic syndrome in children, and 4) Children with nephrotic syndrome who were nottolerant of steroid therapy or were considered for immunosuppressive drugs. Results: A total of 155renal biopsies were taken. Out of these 90 were male patients and 65 were female. The most commonhistopathological lesion among children population was Minimal Change Disease (42.66%) followedby Focal Segmental Glomerulosclerosis (25.33%) and Membranous Glomerulonephritis (16.0%).Nephrotic range proteinuria was most prevalent in Minimal Change Disease and MembranousGlomerulonephritis followed by Focal Segmental Glomerulosclerosis. Non-nephrotic range proteinuriawas mostly seen in patients with Membranoprolifirative Glomerulonephritis. Conclusion: In paediatricpopulation, Minimal Change Disease is the most commonly encountered glomerulopathy, followed byFocal Segmental Glomerulosclerosis and Membranous Glomerulonephritis.Keywords: Nephrotic Syndrome, Renal biopsy, Proteinuria, Glomerulopathy

References

Marwath DS, Korbet SM. Timing of complications in

percutaneous renal biopsy: What is the optimal period of

observation? Am J Kidney Dis 1996;28:47–52.

Mendelssohn DC, Cole EH. Outcomes of percutaneous kidney

biopsy, including those of solitary native kidneys. Am J Kidney

Dis 1995;26:580–5.

Burstein DM, Schwartz MM, Korbet SM. Percutaneous renal

biopsy with the use of real-time ultrasound. Am J Nephrol

;11:195–200.

Korbet SM. Percutaneous renal biopsy. Semin Nephrol

;22:254–67.

Fraser IR, Fairley KF. Renal biopsy as an outpatient procedure.

Am J Kidney Dis 1995;25:876–8.

Jones B, Puvaneswary M, Nanra R, Trevillian P, Carney S,

Gillies A. Reduced duration of bed rest after percutaneous renal

biopsy. Clin Nephrol 1991;35:44–5.

Simckes AM, Blowey D, Gyves KM, Alon US. Success and

safety of same-day kidney biopsy in children and adolescents.

Pediatr Nephrol 2000;14:946–52.

Aziz F, Qureshi AM. Nephrotic Syndrome: Minimal Change

Disease. J Ayub Med Coll Abbottabad 2001;13(4):35–40.

Lakhana NK, Khan H, Butt G. Renal Biopsy findings in

Childhood Nephrosis. J Rawal Med Coll 2002;6(2):57–9.

Hafeez F, Rasool F, Hamid T. Renal Biopsy in childhood

Nephrotic Syndrome. J Coll Physicians Surg Pak

;12(8):454–7.

Baloch GR, Butt TK, Ahmad TM. Experience of renal biopsy

in children. Pak Ped J 2000;24(2):51–5.

Khoo JJ, Pee S, Thevarajah B, Yap YC, Chin CK. Biopsy

proven childhood GN in Johor. Med J Malaysia

;59(2):218–25.

Yap HK, Murugasu B, Saw AH, Chiang GS, Tay JS, Wong

HB, et al. Pattern of glomerulonephritis in Singapore children–

a renal biopsy perspective. Ann Acad Med Singapore

;18(1):35–9.s

Yaqoob N, Malik JM, Latif N, Ahamad W, Yousaf N. An

audit of renal biopsies. Rawal Med J 2000;3:13–5.

Ori Y, Neuman H, Chagnac A, Siegal A, Tobar A, Itkin M, et

al. Using automated biopsy gun with real-time ultrasound for

native renal biopsy. Isr Med Assoc J 2002;4:698–701.

Published

2010-06-01